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class="interlanguage-link interwiki-bs mw-list-item"><a href="https://bs.wikipedia.org/wiki/Porfirija_cutanea_tarda" title="Porfirija cutanea tarda – Bosnian" lang="bs" hreflang="bs" data-title="Porfirija cutanea tarda" data-language-autonym="Bosanski" data-language-local-name="Bosnian" class="interlanguage-link-target"><span>Bosanski</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Porphyria_cutanea_tarda" title="Porphyria cutanea tarda – German" lang="de" hreflang="de" data-title="Porphyria cutanea tarda" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Porfiria_cut%C3%A1nea_tarda" title="Porfiria cutánea tarda – Spanish" lang="es" hreflang="es" data-title="Porfiria cutánea tarda" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Larruazaleko_porfiria_berantiar" title="Larruazaleko porfiria berantiar – Basque" lang="eu" hreflang="eu" data-title="Larruazaleko porfiria berantiar" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-hr mw-list-item"><a href="https://hr.wikipedia.org/wiki/Porfirija_cutanea_tarda" title="Porfirija cutanea tarda – Croatian" lang="hr" hreflang="hr" data-title="Porfirija cutanea tarda" data-language-autonym="Hrvatski" data-language-local-name="Croatian" class="interlanguage-link-target"><span>Hrvatski</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Porphyria_cutanea_tarda" title="Porphyria cutanea tarda – Dutch" lang="nl" hreflang="nl" data-title="Porphyria cutanea tarda" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Porfiria_cut%C3%A2nea_tardia" title="Porfiria cutânea tardia – Portuguese" lang="pt" hreflang="pt" data-title="Porfiria cutânea tardia" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%9A%D0%B0%D1%81%D0%BD%D0%B0_%D0%BA%D0%BE%D0%B6%D0%BD%D0%B0_%D0%BF%D0%BE%D1%80%D1%84%D0%B8%D1%80%D0%B8%D1%98%D0%B0" title="Касна кожна порфирија – Serbian" lang="sr" hreflang="sr" data-title="Касна кожна порфирија" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li> 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<div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Porphyria cutanea tarda</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">PCT</td></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><span typeof="mw:File"><a href="/wiki/File:Blister_in_porphyria_cutanea_tarda.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/0/0d/Blister_in_porphyria_cutanea_tarda.jpg/250px-Blister_in_porphyria_cutanea_tarda.jpg" decoding="async" width="250" height="332" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/0/0d/Blister_in_porphyria_cutanea_tarda.jpg/375px-Blister_in_porphyria_cutanea_tarda.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/0/0d/Blister_in_porphyria_cutanea_tarda.jpg/500px-Blister_in_porphyria_cutanea_tarda.jpg 2x" data-file-width="1692" data-file-height="2250" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data">Blister on the hand of a person with porphyria cutanea tarda</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Endocrinology" title="Endocrinology">Endocrinology</a> <span class="penicon autoconfirmed-show"><span class="mw-valign-text-top" typeof="mw:File/Frameless"><a href="https://www.wikidata.org/wiki/Q1479497?uselang=en#P1995" title="Edit this on Wikidata"><img alt="Edit this on Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></span></td></tr></tbody></table> <p><b>Porphyria cutanea tarda</b> is the most common subtype of <a href="/wiki/Porphyria" title="Porphyria">porphyria</a>.<sup id="cite_ref-pmid17360334_1-0" class="reference"><a href="#cite_note-pmid17360334-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> The disease is named because it is a porphyria that often presents with skin manifestations later in life. The disorder results from low levels of the <a href="/wiki/Enzyme" title="Enzyme">enzyme</a> responsible for the <a href="/wiki/Uroporphyrinogen_III_decarboxylase" title="Uroporphyrinogen III decarboxylase">fifth step</a> in <a href="/wiki/Heme" title="Heme">heme</a> production. Heme is a vital molecule for all of the body's organs. It is a component of <a href="/wiki/Hemoglobin" title="Hemoglobin">hemoglobin</a>, the molecule that carries <a href="/wiki/Oxygen" title="Oxygen">oxygen</a> in the blood. </p><p><a href="/wiki/Hepatoerythropoietic_porphyria" title="Hepatoerythropoietic porphyria">Hepatoerythropoietic porphyria</a> has been described as a <a href="/wiki/Homozygous" class="mw-redirect" title="Homozygous">homozygous</a> form of porphyria cutanea tarda,<sup id="cite_ref-Dorlands_2-0" class="reference"><a href="#cite_note-Dorlands-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> although it can also be caused if two different mutations occur at the same locus. </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Symptoms_and_signs">Symptoms and signs</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Porphyria_cutanea_tarda&action=edit&section=1" title="Edit section: Symptoms and signs"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Porphyria cutanea tarda (PCT) is recognized as the most prevalent subtype of porphyritic diseases.<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p><p>PCT is characterized by <a href="/wiki/Onycholysis" title="Onycholysis">onycholysis</a> and blistering of the skin in areas that receive higher levels of exposure to sunlight. The primary cause is a deficiency of <a href="/wiki/Uroporphyrinogen_decarboxylase" class="mw-redirect" title="Uroporphyrinogen decarboxylase">uroporphyrinogen decarboxylase</a> (UROD), a <a href="/wiki/Cytosolic" class="mw-redirect" title="Cytosolic">cytosolic</a> enzyme that is a step in the <a href="/wiki/Enzymatic_pathway" class="mw-redirect" title="Enzymatic pathway">enzymatic pathway</a> that leads to the synthesis of heme. Behind the direct cause there are a number of genetic and environmental risk factors.<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p><p>Patients who are diagnosed with PCT typically seek treatment following the development of <a href="/wiki/Photosensitivity" title="Photosensitivity">photosensitivities</a> causing <a href="/wiki/Blisters" class="mw-redirect" title="Blisters">blisters</a> and erosions on exposed areas of the <a href="/wiki/Skin" title="Skin">skin</a>. This is usually observed in the face, hands, forearms, and lower legs. Healing is slow and leaves <a href="/wiki/Scarring" class="mw-redirect" title="Scarring">scarring</a>. Though blisters are the most common skin manifestations of PCT, other skin manifestations include <a href="/wiki/Hyperpigmentation" title="Hyperpigmentation">hyperpigmentation</a> (similar to a tan) and <a href="/wiki/Hypertrichosis" title="Hypertrichosis">hypertrichosis</a> (mainly on the cheeks) also occur. PCT is a chronic condition, with external symptoms often subsiding and recurring as a result of multiple factors. In addition to the skin lesions, chronic <a href="/wiki/Liver_disease" title="Liver disease">liver disease</a> is very common in patients with sporadic PCT. This involves <a href="/wiki/Hepatic_fibrosis" class="mw-redirect" title="Hepatic fibrosis">hepatic fibrosis</a> (scarring of the liver), and <a href="/wiki/Inflammation" title="Inflammation">inflammation</a>. However, liver problems are less common in patients with the <a href="/wiki/Heredity" title="Heredity">inherited</a> form of the <a href="/wiki/Disease" title="Disease">disease</a>.<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Additionally, patients will often void a wine-red color urine with an increased concentration of uroporphyrin I due to their enzymatic deficiency.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Vitamin,_mineral,_and_enzyme_deficiencies"><span id="Vitamin.2C_mineral.2C_and_enzyme_deficiencies"></span>Vitamin, mineral, and enzyme deficiencies</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Porphyria_cutanea_tarda&action=edit&section=2" title="Edit section: Vitamin, mineral, and enzyme deficiencies"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Certain vitamin and minerals deficiencies are common in people with porphyria cutanea tarda. The most common deficiencies are <a href="/wiki/Beta-Carotene" class="mw-redirect" title="Beta-Carotene">beta-Carotene</a>,<sup id="cite_ref-auto_7-0" class="reference"><a href="#cite_note-auto-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> retinol,<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> vitamin A<sup id="cite_ref-auto1_9-0" class="reference"><a href="#cite_note-auto1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> and vitamin C. Beta-Carotene is required to synthesize vitamin A and vitamin A is needed to synthesize retinol. A lack of <a href="/wiki/Retinol-binding_protein" title="Retinol-binding protein">retinol-binding protein</a> is due to a lack of retinol which is required to trigger its production.<sup id="cite_ref-auto1_9-1" class="reference"><a href="#cite_note-auto1-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p><p>Porphyrins interact with iron, absorbing photons to create <a href="/wiki/Reactive_oxygen_species" title="Reactive oxygen species">reactive oxygen species</a> is the mechanism of action causing the itchy, painful blisters of PCT.<sup id="cite_ref-auto_7-1" class="reference"><a href="#cite_note-auto-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> The reactive oxygen species consume the skin antioxidants beta-carotene, vitamin E, and vitamin C. Supplementation of these three vitamins reduces the oxidation and potentially diminishes the severity of blister formation.<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> No single one of the three vitamins can inhibit the damaging effects of oxidized porphyrins, specifically uroporphyrins and coproporphyrins, but all three working together synergistically are capable of neutralizing their damaging effects.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2021)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="Genetics">Genetics</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Porphyria_cutanea_tarda&action=edit&section=3" title="Edit section: Genetics"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-halign-left" typeof="mw:File/Thumb"><a href="/wiki/File:Uroporphyrinogen-decarboxylase.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/d/d6/Uroporphyrinogen-decarboxylase.svg/400px-Uroporphyrinogen-decarboxylase.svg.png" decoding="async" width="400" height="172" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/d6/Uroporphyrinogen-decarboxylase.svg/600px-Uroporphyrinogen-decarboxylase.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/d/d6/Uroporphyrinogen-decarboxylase.svg/800px-Uroporphyrinogen-decarboxylase.svg.png 2x" data-file-width="512" data-file-height="220" /></a><figcaption>The reaction catalyzed by UroD</figcaption></figure> <figure class="mw-default-size mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:Autosomal_dominant_-_en.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/4/4e/Autosomal_dominant_-_en.svg/220px-Autosomal_dominant_-_en.svg.png" decoding="async" width="220" height="376" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/4e/Autosomal_dominant_-_en.svg/330px-Autosomal_dominant_-_en.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/4e/Autosomal_dominant_-_en.svg/440px-Autosomal_dominant_-_en.svg.png 2x" data-file-width="738" data-file-height="1260" /></a><figcaption>20% of cases of porphyria cutanea tarda are inherited in an <a href="/wiki/Autosomal_dominant" class="mw-redirect" title="Autosomal dominant">autosomal dominant</a> pattern.</figcaption></figure> <p>Inherited mutations in the <i><a href="/wiki/UROD" class="mw-redirect" title="UROD">UROD</a></i> <a href="/wiki/Gene" title="Gene">gene</a> cause about 20% of cases (the other 80% of cases do not have <a href="/wiki/Mutation" title="Mutation">mutations</a> in UROD, and are classified as sporadic). UROD makes an enzyme called <a href="/wiki/Uroporphyrinogen_III_decarboxylase" title="Uroporphyrinogen III decarboxylase">uroporphyrinogen III decarboxylase</a>, which is critical to the chemical process that leads to heme production. The activity of this enzyme is usually reduced by 50% in all tissues in people with the inherited form of the condition.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2021)">citation needed</span></a></i>]</sup> </p><p>Nongenetic factors such as excess <a href="/wiki/Iron" title="Iron">iron</a> or partially genetic factors such as <a href="/wiki/Alcohol_use_disorder" class="mw-redirect" title="Alcohol use disorder">alcohol use disorder</a> and others listed above can increase the demand for heme and the enzymes required to make heme. The combination of this increased demand and reduced activity of uroporphyrinogen decarboxylase disrupts heme production and allows byproducts of the process to accumulate in the body, triggering the signs and symptoms of porphyria cutanea tarda.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2021)">citation needed</span></a></i>]</sup> </p><p>The <i><a href="/wiki/HFE_gene" class="mw-redirect" title="HFE gene">HFE</a></i> gene makes a protein that helps cells regulate the absorption of iron from the digestive tract and into the cells of the body. Certain mutations in the <i>HFE</i> gene cause <a href="/wiki/Hemochromatosis" class="mw-redirect" title="Hemochromatosis">hemochromatosis</a> (an <a href="/wiki/Iron_overload_disorder" class="mw-redirect" title="Iron overload disorder">iron overload disorder</a>). People who have these mutations are also at an increased risk of developing porphyria cutanea tarda.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2021)">citation needed</span></a></i>]</sup> </p><p>In the 20% of cases where porphyria cutanea tarda is inherited, it is inherited in an <a href="/wiki/Autosomal_dominant" class="mw-redirect" title="Autosomal dominant">autosomal dominant</a> pattern, which means one copy of the altered gene is sufficient to decrease enzyme activity and cause the signs and symptoms of the disorder.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2021)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Other">Other</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Porphyria_cutanea_tarda&action=edit&section=4" title="Edit section: Other"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>While inherited deficiencies in uroporphyrinogen decarboxylase often lead to the development of PCT, there are a number of risk factors that can both cause and exacerbate the symptoms of this disease. One of the most common risk factors observed is infection with the <a href="/wiki/Hepatitis_C" title="Hepatitis C">Hepatitis C</a> virus.<sup id="cite_ref-pmid18855993_11-0" class="reference"><a href="#cite_note-pmid18855993-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> One review of a collection of PCT studies noted Hepatitis C infection in 50% of documented cases of PCT. Additional risk factors include alcohol use disorder, excess iron (from iron supplements as well as cooking on cast iron skillets), and exposure to chlorinated cyclic hydrocarbons and <a href="/wiki/Agent_Orange" title="Agent Orange">Agent Orange</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2021)">citation needed</span></a></i>]</sup> </p><p>It can be a <a href="/wiki/Paraneoplastic_phenomenon" class="mw-redirect" title="Paraneoplastic phenomenon">paraneoplastic phenomenon</a>.<sup id="cite_ref-pmid17891697_12-0" class="reference"><a href="#cite_note-pmid17891697-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Exacerbating_factors">Exacerbating factors</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Porphyria_cutanea_tarda&action=edit&section=5" title="Edit section: Exacerbating factors"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li>Alcohol<sup id="cite_ref-pmid17298224_13-0" class="reference"><a href="#cite_note-pmid17298224-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup></li> <li>Estrogen</li> <li>Iron<sup id="cite_ref-pmid10189391_14-0" class="reference"><a href="#cite_note-pmid10189391-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup></li> <li>Hepatitis C virus<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading2"><h2 id="Pathogenesis">Pathogenesis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Porphyria_cutanea_tarda&action=edit&section=6" title="Edit section: Pathogenesis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Porphyria cutanea tarda is primarily caused by uroporphyrinogen decarboxylase deficiency (UROD). Uroporphyrinogen decarboxylase occurs in nature as a homodimer of two subunits. It participates in the fifth step in heme synthesis pathway, and is active in the cytosol. This enzymatic conversion results in coproporphyrinogen III as the primary product. This is accomplished by the clockwise removal of the four carboxyl groups present in the cyclic uroporphyrinogen III molecule. Therefore, a deficiency in this enzyme causes the aforementioned buildup of uroporphyrinogen and hepta-carboxylic <a href="/wiki/Porphyrinogen" title="Porphyrinogen">porphyrinogen</a>, and to a lesser extent hexa-carboxylic porphyrinogen, and penta-carboxylic porphyrinogen in the urine, which can be helpful in the diagnosis of this disorder.<sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> </p><p>The dermatological symptoms of PCT that include blistering and lesions on sun-exposed areas of the skin are caused by a buildup of porphyrin compounds (specifically uroporphyrinogen) close to the surface of the skin that have been oxidized by free radicals or sunlight.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> The oxidized porphyrins initiate degranulation of dermal <a href="/wiki/Mast_cells" class="mw-redirect" title="Mast cells">mast cells</a>,<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> which release proteases that catabolize the surrounding proteins.<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> This begins a cell-mediated positive feedback loop which matches the description of a <a href="/wiki/Type_IV_hypersensitivity" title="Type IV hypersensitivity">type 4 delayed hypersensitivity</a> reaction.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (December 2016)">citation needed</span></a></i>]</sup> The resulting blisters, therefore, do not appear immediately but begin to show up 2–3 days after sun exposure. Due to the highly conjugated structure of porphyrins involving alternating single and double carbon bonds, these compounds exhibit a deep purple color, resulting in the discoloration observed in the skin. Excess alcohol intake decreases <a href="/wiki/Hepcidin" title="Hepcidin">hepcidin</a> production which leads to increased iron absorption from the gut and an increase in oxidative stress. This oxidative stress then leads to inhibition of uroporphyrinogen decarboxylase, creating an excess of uroporphyrinogen III which is oxidized from the relatively harmless porphyrinogens into their oxidized porphyrins form.<sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> Concentrated instances of oxidative stress (alcohol, physical trauma, psychological stress, etc.) cause the liver to hemorrhage these porphyrins into the blood stream where they are then susceptible to oxidation.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2021)">citation needed</span></a></i>]</sup> </p><p>The strong association of PCT with Hepatitis C virus infection is not entirely understood. Studies have suggested that the cytopathic effect of the virus on hepatocytes can lead to the release of free iron. This iron can disrupt the activity of cytochrome p450, releasing activated oxygen species. These can oxidize the UROD substrate uroporphyrinogen, which can result in the inhibition of UROD and lead to deficient activity of this key enzyme.<sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> </p><p>Excess alcohol use is frequently associated with both inducing PCT<sup id="cite_ref-urleMedicine/Stedman_Medical_Dictionary_Lookup!_23-0" class="reference"><a href="#cite_note-urleMedicine/Stedman_Medical_Dictionary_Lookup!-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> and aggravating a preexisting diagnosis of the disorder. It is thought to do so by causing oxidative damage to liver cells, resulting in oxidized species of uroporphyrinogen that inhibit the activity of hepatic UROD. It is also felt to increase the uptake of iron in liver cells, leading to further oxidation of uroporphyrinogen by the release of activated oxygen species. Additionally, exposure to chlorinated cyclic hydrocarbons can lead to a deficiency in the activity of uroporphyrinogen decarboxylase, causing the buildup of excess uroporphyrinogen. Additionally, alcohol has been shown to increase the activity of the delta-aminolevulinic acid synthetase (ALA synthetase), the rate-limiting enzymatic step in heme synthesis in the mitochondria, in rats.<sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> Therefore, alcohol consumption may increase the production of uroporphyrinogen, exacerbating symptoms in individuals with porphyria cutanea tarda.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (December 2017)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Porphyria_cutanea_tarda&action=edit&section=7" title="Edit section: Diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>While the most common symptom of PCT is the appearance of skin lesions and blistering, their appearance is not conclusive. Laboratory testing commonly reveals high levels of <a href="/wiki/Uroporphyrinogen" title="Uroporphyrinogen">uroporphyrinogen</a> in the urine, clinically referred to as uroporphyrinogenuria. Additionally, testing for common risk factors such as <a href="/wiki/Hepatitis_C" title="Hepatitis C">hepatitis C</a> and <a href="/wiki/Hemochromatosis" class="mw-redirect" title="Hemochromatosis">hemochromatosis</a> is strongly suggested, as their high prevalence in patients with PCT may require additional treatment. If clinical appearance of PCT is present, but laboratories are negative, the diagnosis of <a href="/wiki/Pseudoporphyria" title="Pseudoporphyria">pseudoporphyria</a> should be seriously considered.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2021)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Classification">Classification</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Porphyria_cutanea_tarda&action=edit&section=8" title="Edit section: Classification"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Some sources divide PCT into two types: sporadic and familial.<sup id="cite_ref-Dorlands_2-1" class="reference"><a href="#cite_note-Dorlands-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Other sources include a third type,<sup id="cite_ref-pmid17627795_25-0" class="reference"><a href="#cite_note-pmid17627795-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> but this is less common. </p> <table class="wikitable"> <tbody><tr> <th>Type </th> <th><a href="/wiki/OMIM" class="mw-redirect" title="OMIM">OMIM</a> </th> <th>Description </th></tr> <tr> <td>Type I ("sporadic") </td> <td><a rel="nofollow" class="external text" href="https://omim.org/entry/176090">176090</a> </td> <td>Type I porphyria cutanea tarda, the sporadic form, is indicated by UROD deficiency that is observed only in hepatic cells and nowhere else in the body. Genetically, these individuals will not exhibit deficiency in the UROD gene, although other genetic factors such as HFE deficiency (resulting in hemochromatosis and the buildup of iron in the liver) are thought to play a key role. Typically in these individuals, a variety of risk factors such as alcohol use disorder and Hepatitis C virus infection co-occur to result in the clinical manifestation of PCT. </td></tr> <tr> <td>Type II ("familial") </td> <td><a rel="nofollow" class="external text" href="https://omim.org/entry/176100">176100</a> </td> <td>Patients exhibiting Type II PCT have a specific deficiency in the UROD gene, passed down in an autosomal dominant pattern. Those possessing this deficiency are heterozygous for the UROD gene. They do not show a complete lack of functional uroporphyrinogen decarboxylase, only a deficient form of the enzyme that is marked by reduced conversion of uroporphyrinogen to coproporphyrinogen. Therefore, the expression of uroporphyrinogen decarboxylase will be reduced throughout the body of these individuals, while it is isolated to the liver in Type I patients. While this genetic deficiency is the main distinction between Type I and Type II PCT, the risk factors mentioned before are often seen in patients presenting with Type II PCT. In fact, many people who possess the deficient UROD gene often go their entire lives without having a clinical manifestation of PCT symptoms. </td></tr> <tr> <td>Type III </td> <td>- </td> <td>The least common is Type III, which is no different from Type I insofar as the patients possess normal UROD genes. Despite this, Type III PCT is observed in more than one family member, indicating a genetic component unrelated to the expression of uroporphyrinogen decarboxylase. </td></tr></tbody></table> <p>One study used 74% as the cutoff for UROD activity, with those patients under that number being classified as type II, and those above classified as type III if there was a family history, and type I if there was not.<sup id="cite_ref-pmid12699242_26-0" class="reference"><a href="#cite_note-pmid12699242-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> </p><p>Genetic variants associated with <a href="/wiki/Hemochromatosis" class="mw-redirect" title="Hemochromatosis">hemochromatosis</a> have been observed in PCT patients,<sup id="cite_ref-pmid17298224_13-1" class="reference"><a href="#cite_note-pmid17298224-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> which may help explain inherited PCT not associated with UROD. </p> <div class="mw-heading mw-heading2"><h2 id="Treatment">Treatment</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Porphyria_cutanea_tarda&action=edit&section=9" title="Edit section: Treatment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Since PCT is a chronic condition, a comprehensive management of the disease is the most effective means of treatment. Primarily, it is key that patients diagnosed with PCT avoid alcohol consumption, iron supplements, excess exposure to sunlight (especially in the summer), as well as estrogen and chlorinated cyclic hydrocarbons, all of which can potentially exacerbate the disorder. Additionally, the management of excess iron (due to the commonality of hemochromatosis in PCT patients) can be achieved through <a href="/wiki/Phlebotomy" title="Phlebotomy">phlebotomy</a>, whereby blood is systematically drained from the patient. A borderline iron deficiency has been found to have a protective effect by limiting heme synthesis. In the absence of iron, which is to be incorporated in the porphyrin formed in the last step of the synthesis, the mRNA of erythroid 5-aminolevulinate synthase (ALAS-2) is blocked by attachment of an iron-responsive element (IRE) binding cytosolic protein, and transcription of this key enzyme is inhibited.<sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> </p><p>Low doses of <a href="/wiki/Antimalarials" class="mw-redirect" title="Antimalarials">antimalarials</a> can be used.<sup id="cite_ref-28" class="reference"><a href="#cite_note-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> Orally ingested chloroquine is completely absorbed in the gut and is preferentially concentrated in the liver, spleen, and kidneys.<sup id="cite_ref-Aralen_29-0" class="reference"><a href="#cite_note-Aralen-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> They work by removing excess porphyrins from the liver via increasing the excretion rate by forming a coordination complex with the iron center of the porphyrin as well as an intramolecular hydrogen bond between a propionate side chain of the porphyrin and the protonated quinuclidine nitrogen atom of either alkaloid.<sup id="cite_ref-30" class="reference"><a href="#cite_note-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> Due to the presence of the chlorine atom, the entire complex is more water-soluble allowing the kidneys to preferentially remove it from the blood stream and expel it through urination.<sup id="cite_ref-Aralen_29-1" class="reference"><a href="#cite_note-Aralen-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-31" class="reference"><a href="#cite_note-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-32" class="reference"><a href="#cite_note-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> Chloroquine treatment can induce porphyria attacks within the first couple of months of treatment due to the mass mobilization of porphyrins from the liver into the blood stream.<sup id="cite_ref-Aralen_29-2" class="reference"><a href="#cite_note-Aralen-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> Complete remission can be seen within 6–12 months as each dose of antimalarial can only remove a finite amount of porphyrins and there are generally decades of accumulation to be cleared. Originally, higher doses were used to treat the condition but are no longer recommended because of liver toxicity.<sup id="cite_ref-33" class="reference"><a href="#cite_note-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-34" class="reference"><a href="#cite_note-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> Finally, due to the strong association between PCT and Hepatitis C, the treatment of Hepatitis C (if present) is vital to the effective treatment of PCT. <a href="/wiki/Chloroquine" title="Chloroquine">Chloroquine</a>, <a href="/wiki/Hydroxychloroquine" title="Hydroxychloroquine">hydroxychloroquine</a>, and <a href="/wiki/Venesection" class="mw-redirect" title="Venesection">venesection</a> are typically employed in the management strategy.<sup id="cite_ref-35" class="reference"><a href="#cite_note-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Porphyria_cutanea_tarda&action=edit&section=10" title="Edit section: Epidemiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>PCT <a href="/wiki/Prevalence" title="Prevalence">prevalence</a> is estimated at 1 in 10,000.<sup id="cite_ref-Hann2006_36-0" class="reference"><a href="#cite_note-Hann2006-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> An estimated 80% of porphyria cutanea tarda cases are sporadic. The exact frequency is not clear because many people with the condition never experience symptoms and those that do are often misdiagnosed with anything ranging from <a href="/wiki/Idiopathic" class="mw-redirect" title="Idiopathic">idiopathic</a> <a href="/wiki/Photodermatitis" title="Photodermatitis">photodermatitis</a> and seasonal allergies to <a href="/wiki/Hives" title="Hives">hives</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2021)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Porphyria_cutanea_tarda&action=edit&section=11" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-pmid17360334-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-pmid17360334_1-0">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFPhillipsBergoniaReillyFranklin2007" class="citation journal cs1">Phillips, J. D.; Bergonia, H. A.; Reilly, C. A.; Franklin, M. R.; Kushner, J. P. (2007). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1820519">"A porphomethene inhibitor of uroporphyrinogen decarboxylase causes porphyria cutanea tarda"</a>. <i>Proceedings of the National Academy of Sciences</i>. <b>104</b> (12): 5079–84. <a href="/wiki/Bibcode_(identifier)" class="mw-redirect" title="Bibcode (identifier)">Bibcode</a>:<a rel="nofollow" class="external text" href="https://ui.adsabs.harvard.edu/abs/2007PNAS..104.5079P">2007PNAS..104.5079P</a>. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1073%2Fpnas.0700547104">10.1073/pnas.0700547104</a></span>. <a href="/wiki/JSTOR_(identifier)" class="mw-redirect" title="JSTOR (identifier)">JSTOR</a> <a rel="nofollow" class="external text" href="https://www.jstor.org/stable/25427147">25427147</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1820519">1820519</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/17360334">17360334</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Proceedings+of+the+National+Academy+of+Sciences&rft.atitle=A+porphomethene+inhibitor+of+uroporphyrinogen+decarboxylase+causes+porphyria+cutanea+tarda&rft.volume=104&rft.issue=12&rft.pages=5079-84&rft.date=2007&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC1820519%23id-name%3DPMC&rft_id=https%3A%2F%2Fwww.jstor.org%2Fstable%2F25427147%23id-name%3DJSTOR&rft_id=info%3Abibcode%2F2007PNAS..104.5079P&rft_id=info%3Apmid%2F17360334&rft_id=info%3Adoi%2F10.1073%2Fpnas.0700547104&rft.aulast=Phillips&rft.aufirst=J.+D.&rft.au=Bergonia%2C+H.+A.&rft.au=Reilly%2C+C.+A.&rft.au=Franklin%2C+M.+R.&rft.au=Kushner%2C+J.+P.&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC1820519&rfr_id=info%3Asid%2Fen.wikipedia.org%3APorphyria+cutanea+tarda" class="Z3988"></span></span> </li> <li id="cite_note-Dorlands-2"><span class="mw-cite-backlink">^ <a href="#cite_ref-Dorlands_2-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Dorlands_2-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20090628224336/http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common/dorlands/dorland/seven/000085425.htm">"porphyria cutanea tarda"</a> at <i><a href="/wiki/Dorland%27s_medical_reference_works" title="Dorland's medical reference works">Dorland's Medical Dictionary</a></i></span> </li> <li id="cite_note-3"><span class="mw-cite-backlink"><b><a href="#cite_ref-3">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFDantonLim2007" class="citation journal cs1">Danton, Malcolm; Lim, Chang Kee (2007). "Porphomethene inhibitor of uroporphyrinogen decarboxylase: Analysis by high-performance liquid chromatography/electrospray ionization tandem mass spectrometry". <i>Biomedical Chromatography</i>. <b>21</b> (7): 661–3. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2Fbmc.860">10.1002/bmc.860</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/17516469">17516469</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Biomedical+Chromatography&rft.atitle=Porphomethene+inhibitor+of+uroporphyrinogen+decarboxylase%3A+Analysis+by+high-performance+liquid+chromatography%2Felectrospray+ionization+tandem+mass+spectrometry&rft.volume=21&rft.issue=7&rft.pages=661-3&rft.date=2007&rft_id=info%3Adoi%2F10.1002%2Fbmc.860&rft_id=info%3Apmid%2F17516469&rft.aulast=Danton&rft.aufirst=Malcolm&rft.au=Lim%2C+Chang+Kee&rfr_id=info%3Asid%2Fen.wikipedia.org%3APorphyria+cutanea+tarda" class="Z3988"></span></span> </li> <li id="cite_note-4"><span class="mw-cite-backlink"><b><a href="#cite_ref-4">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFKushnerBarbutoLee1976" class="citation journal cs1">Kushner, J P; Barbuto, A J; Lee, G R (1976). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC333275">"An inherited enzymatic defect in porphyria cutanea tarda: Decreased uroporphyrinogen decarboxylase activity"</a>. <i>Journal of Clinical Investigation</i>. <b>58</b> (5): 1089–97. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1172%2FJCI108560">10.1172/JCI108560</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC333275">333275</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/993332">993332</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+Clinical+Investigation&rft.atitle=An+inherited+enzymatic+defect+in+porphyria+cutanea+tarda%3A+Decreased+uroporphyrinogen+decarboxylase+activity&rft.volume=58&rft.issue=5&rft.pages=1089-97&rft.date=1976&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC333275%23id-name%3DPMC&rft_id=info%3Apmid%2F993332&rft_id=info%3Adoi%2F10.1172%2FJCI108560&rft.aulast=Kushner&rft.aufirst=J+P&rft.au=Barbuto%2C+A+J&rft.au=Lee%2C+G+R&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC333275&rfr_id=info%3Asid%2Fen.wikipedia.org%3APorphyria+cutanea+tarda" class="Z3988"></span></span> </li> <li id="cite_note-5"><span class="mw-cite-backlink"><b><a href="#cite_ref-5">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFDi_PadovaMarchesiCainelliGori1983" class="citation journal cs1">Di Padova, C.; Marchesi, L.; Cainelli, T.; Gori, G.; Podenzani, S.A.; Rovagnati, P.; Rizzardini, M.; Cantoni, L. 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"The management of porphyria cutanea tarda". <i>Clinical and Experimental Dermatology</i>. <b>26</b> (3): 225–32. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1046%2Fj.1365-2230.2001.00825.x">10.1046/j.1365-2230.2001.00825.x</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/11422163">11422163</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:35585037">35585037</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Clinical+and+Experimental+Dermatology&rft.atitle=The+management+of+porphyria+cutanea+tarda&rft.volume=26&rft.issue=3&rft.pages=225-32&rft.date=2001&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A35585037%23id-name%3DS2CID&rft_id=info%3Apmid%2F11422163&rft_id=info%3Adoi%2F10.1046%2Fj.1365-2230.2001.00825.x&rft.aulast=Sarkany&rft.aufirst=R.+P.+E.&rfr_id=info%3Asid%2Fen.wikipedia.org%3APorphyria+cutanea+tarda" class="Z3988"></span></span> </li> <li id="cite_note-Hann2006-36"><span class="mw-cite-backlink"><b><a href="#cite_ref-Hann2006_36-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFArceciHannSmith2006" class="citation book cs1">Arceci, Robert.; Hann, Ian M.; Smith, Owen P. (2006). <i>Pediatric hematolog</i>. Malden MA: Blackwell. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-1-4051-3400-2" title="Special:BookSources/978-1-4051-3400-2"><bdi>978-1-4051-3400-2</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Pediatric+hematolog&rft.place=Malden+MA&rft.pub=Blackwell&rft.date=2006&rft.isbn=978-1-4051-3400-2&rft.aulast=Arceci&rft.aufirst=Robert.&rft.au=Hann%2C+Ian+M.&rft.au=Smith%2C+Owen+P.&rfr_id=info%3Asid%2Fen.wikipedia.org%3APorphyria+cutanea+tarda" class="Z3988"></span><sup class="noprint Inline-Template" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citing_sources" title="Wikipedia:Citing sources"><span title="This citation requires a reference to the specific page or range of pages in which the material appears. (December 2016)">page needed</span></a></i>]</sup></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Porphyria_cutanea_tarda&action=edit&section=12" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a rel="nofollow" class="external text" href="https://rarediseases.info.nih.gov/diseases/7433/disease">Porphyria cutanea tarda</a> at <a href="/wiki/National_Institutes_of_Health" title="National Institutes of Health">NIH</a>'s Office of <a href="/wiki/Rare_disease" title="Rare disease">Rare Diseases</a></li></ul> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1236075235">.mw-parser-output .navbox{box-sizing:border-box;border:1px solid #a2a9b1;width:100%;clear:both;font-size:88%;text-align:center;padding:1px;margin:1em auto 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.navbox-abovebelow,.mw-parser-output .navbox-group,.mw-parser-output .navbox-subgroup .navbox-title{background-color:#ddf}.mw-parser-output .navbox-subgroup .navbox-group,.mw-parser-output .navbox-subgroup .navbox-abovebelow{background-color:#e6e6ff}.mw-parser-output .navbox-even{background-color:#f7f7f7}.mw-parser-output .navbox-odd{background-color:transparent}.mw-parser-output .navbox .hlist td dl,.mw-parser-output .navbox .hlist td ol,.mw-parser-output .navbox .hlist td ul,.mw-parser-output .navbox td.hlist dl,.mw-parser-output .navbox td.hlist ol,.mw-parser-output .navbox td.hlist ul{padding:0.125em 0}.mw-parser-output .navbox .navbar{display:block;font-size:100%}.mw-parser-output .navbox-title .navbar{float:left;text-align:left;margin-right:0.5em}body.skin--responsive .mw-parser-output .navbox-image img{max-width:none!important}@media print{body.ns-0 .mw-parser-output .navbox{display:none!important}}</style><style data-mw-deduplicate="TemplateStyles:r1129693374">.mw-parser-output .hlist dl,.mw-parser-output .hlist ol,.mw-parser-output .hlist ul{margin:0;padding:0}.mw-parser-output .hlist dd,.mw-parser-output .hlist dt,.mw-parser-output .hlist li{margin:0;display:inline}.mw-parser-output .hlist.inline,.mw-parser-output .hlist.inline dl,.mw-parser-output .hlist.inline ol,.mw-parser-output .hlist.inline ul,.mw-parser-output .hlist dl dl,.mw-parser-output .hlist dl ol,.mw-parser-output .hlist dl ul,.mw-parser-output .hlist ol dl,.mw-parser-output .hlist ol ol,.mw-parser-output .hlist ol ul,.mw-parser-output .hlist ul dl,.mw-parser-output .hlist ul ol,.mw-parser-output .hlist ul ul{display:inline}.mw-parser-output .hlist .mw-empty-li{display:none}.mw-parser-output .hlist dt::after{content:": "}.mw-parser-output .hlist dd::after,.mw-parser-output .hlist li::after{content:" · ";font-weight:bold}.mw-parser-output .hlist dd:last-child::after,.mw-parser-output .hlist dt:last-child::after,.mw-parser-output .hlist li:last-child::after{content:none}.mw-parser-output .hlist dd dd:first-child::before,.mw-parser-output .hlist dd dt:first-child::before,.mw-parser-output .hlist dd li:first-child::before,.mw-parser-output .hlist dt dd:first-child::before,.mw-parser-output .hlist dt dt:first-child::before,.mw-parser-output .hlist dt li:first-child::before,.mw-parser-output .hlist li dd:first-child::before,.mw-parser-output .hlist li dt:first-child::before,.mw-parser-output .hlist li li:first-child::before{content:" (";font-weight:normal}.mw-parser-output .hlist dd dd:last-child::after,.mw-parser-output .hlist dd dt:last-child::after,.mw-parser-output .hlist dd li:last-child::after,.mw-parser-output .hlist dt dd:last-child::after,.mw-parser-output .hlist dt dt:last-child::after,.mw-parser-output .hlist dt li:last-child::after,.mw-parser-output .hlist li dd:last-child::after,.mw-parser-output .hlist li dt:last-child::after,.mw-parser-output .hlist li li:last-child::after{content:")";font-weight:normal}.mw-parser-output .hlist ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-label="Navbox" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q1479497" class="extiw" title="d:Q1479497">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-11" title="ICD-11">11</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse/latest-release/mms/en#370983230">5C58.10</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/E80.1">E80.1</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a></b>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=277.1">277.1</a></li><li><b><a href="/wiki/Online_Mendelian_Inheritance_in_Man" title="Online Mendelian Inheritance in Man">OMIM</a></b>: <a rel="nofollow" class="external text" href="https://omim.org/entry/176100">176100</a></li><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D017119">D017119</a></li><li><b><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a></b>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb10376.htm">10376</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/EMedicine" title="EMedicine">eMedicine</a></b>: <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/derm/344-overview">derm/344</a></li><li><b><a href="/wiki/National_Organization_for_Rare_Disorders" title="National Organization for Rare Disorders">NORD</a></b>: <a rel="nofollow" class="external text" href="https://rarediseases.org/rare-diseases/porphyria-cutanea-tarda">porphyria-cutanea-tarda</a></li><li><b><a href="/wiki/GARD" class="mw-redirect" title="GARD">GARD</a></b>: <a rel="nofollow" class="external text" href="https://rarediseases.info.nih.gov/diseases/7433/porphyria-cutanea-tarda">porphyria-cutanea-tarda</a></li><li><b><a href="/wiki/Orphanet" title="Orphanet">Orphanet</a></b>: <a rel="nofollow" class="external text" href="https://www.orpha.net/consor/cgi-bin/OC_Exp.php?lng=en&Expert=101330">101330</a></li></ul></div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Diseases_of_the_skin_and_appendages_by_morphology" style="padding:3px"><table class="nowraplinks mw-collapsible mw-collapsed navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Diseases_of_the_skin_and_appendages_by_morphology" title="Template:Diseases of the skin and appendages by morphology"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Diseases_of_the_skin_and_appendages_by_morphology" title="Template talk:Diseases of the skin and appendages by morphology"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Diseases_of_the_skin_and_appendages_by_morphology" title="Special:EditPage/Template:Diseases of the skin and appendages by morphology"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Diseases_of_the_skin_and_appendages_by_morphology" style="font-size:114%;margin:0 4em">Diseases of the skin and appendages by morphology</div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Growths</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Epidermis" title="Epidermis">Epidermal</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Wart" title="Wart">Wart</a></li> <li><a href="/wiki/Callus" title="Callus">Callus</a></li> <li><a href="/wiki/Seborrheic_keratosis" title="Seborrheic keratosis">Seborrheic keratosis</a></li> <li><a href="/wiki/Skin_tag" title="Skin tag">Acrochordon</a></li> <li><a href="/wiki/Molluscum_contagiosum" title="Molluscum contagiosum">Molluscum contagiosum</a></li> <li><a href="/wiki/Actinic_keratosis" title="Actinic keratosis">Actinic keratosis</a></li> <li><a href="/wiki/Squamous-cell_carcinoma" title="Squamous-cell carcinoma">Squamous-cell carcinoma</a></li> <li><a href="/wiki/Basal-cell_carcinoma" title="Basal-cell carcinoma">Basal-cell carcinoma</a></li> <li><a href="/wiki/Merkel-cell_carcinoma" title="Merkel-cell carcinoma">Merkel-cell carcinoma</a></li> <li><a href="/wiki/Nevus_sebaceous" title="Nevus sebaceous">Nevus sebaceous</a></li> <li><a href="/wiki/Trichoepithelioma" title="Trichoepithelioma">Trichoepithelioma</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Pigmented</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Freckle" title="Freckle">Freckles</a></li> <li><a href="/wiki/Lentigo" title="Lentigo">Lentigo</a></li> <li><a href="/wiki/Melasma" title="Melasma">Melasma</a></li> <li><a href="/wiki/Nevus" title="Nevus">Nevus</a></li> <li><a href="/wiki/Melanoma" title="Melanoma">Melanoma</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Dermis" title="Dermis">Dermal</a> and<br />subcutaneous</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Epidermoid_cyst" title="Epidermoid cyst">Epidermal inclusion cyst</a></li> <li><a href="/wiki/Hemangioma" title="Hemangioma">Hemangioma</a></li> <li><a href="/wiki/Benign_fibrous_histiocytoma" class="mw-redirect" title="Benign fibrous histiocytoma">Dermatofibroma (benign fibrous histiocytoma)</a></li> <li><a href="/wiki/Keloid" title="Keloid">Keloid</a></li> <li><a href="/wiki/Lipoma" title="Lipoma">Lipoma</a></li> <li><a href="/wiki/Neurofibroma" title="Neurofibroma">Neurofibroma</a></li> <li><a href="/wiki/Xanthoma" title="Xanthoma">Xanthoma</a></li> <li><a href="/wiki/Kaposi%27s_sarcoma" title="Kaposi's sarcoma">Kaposi's sarcoma</a></li> <li><a href="/wiki/Infantile_digital_fibromatosis" title="Infantile digital fibromatosis">Infantile digital fibromatosis</a></li> <li><a href="/wiki/Granular_cell_tumor" title="Granular cell tumor">Granular cell tumor</a></li> <li><a href="/wiki/Leiomyoma" title="Leiomyoma">Leiomyoma</a></li> <li><a href="/wiki/Lymphangioma_circumscriptum" title="Lymphangioma circumscriptum">Lymphangioma circumscriptum</a></li> <li><a href="/wiki/Myxoid_cyst" title="Myxoid cyst">Myxoid cyst</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Rash" title="Rash">Rashes</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">With<br /> epidermal<br /> involvement</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Eczematous</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Contact_dermatitis" title="Contact dermatitis">Contact dermatitis</a></li> <li><a href="/wiki/Atopic_dermatitis" title="Atopic dermatitis">Atopic dermatitis</a></li> <li><a href="/wiki/Seborrhoeic_dermatitis" title="Seborrhoeic dermatitis">Seborrheic dermatitis</a></li> <li><a href="/wiki/Stasis_dermatitis" title="Stasis dermatitis">Stasis dermatitis</a></li> <li><a href="/wiki/Lichen_simplex_chronicus" title="Lichen simplex chronicus">Lichen simplex chronicus</a></li> <li><a href="/wiki/Darier%27s_disease" title="Darier's disease">Darier's disease</a></li> <li><a href="/wiki/Glucagonoma_syndrome" class="mw-redirect" title="Glucagonoma syndrome">Glucagonoma syndrome</a></li> <li><a href="/wiki/Langerhans_cell_histiocytosis" title="Langerhans cell histiocytosis">Langerhans cell histiocytosis</a></li> <li><a href="/wiki/Lichen_sclerosus" title="Lichen sclerosus">Lichen sclerosus</a></li> <li><a href="/wiki/Pemphigus" title="Pemphigus">Pemphigus foliaceus</a></li> <li><a href="/wiki/Wiskott%E2%80%93Aldrich_syndrome" title="Wiskott–Aldrich syndrome">Wiskott–Aldrich syndrome</a></li> <li><a href="/wiki/Zinc_deficiency" title="Zinc deficiency">Zinc deficiency</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Scale_(dermatology)" class="mw-redirect" title="Scale (dermatology)">Scaling</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Psoriasis" title="Psoriasis">Psoriasis</a></li> <li>Tinea (<a href="/wiki/Tinea_corporis" title="Tinea corporis">Corporis</a></li> <li><a href="/wiki/Tinea_cruris" title="Tinea cruris">Cruris</a></li> <li><a href="/wiki/Athlete%27s_foot" title="Athlete's foot">Pedis</a></li> <li><a href="/wiki/Tinea_manuum" title="Tinea manuum">Manuum</a></li> <li><a href="/wiki/Tinea_faciei" title="Tinea faciei">Faciei</a>)</li> <li><a href="/wiki/Pityriasis_rosea" title="Pityriasis rosea">Pityriasis rosea</a></li> <li><a href="/wiki/Syphilis" title="Syphilis">Secondary syphilis</a></li> <li><a href="/wiki/Mycosis_fungoides" title="Mycosis fungoides">Mycosis fungoides</a></li> <li><a href="/wiki/Systemic_lupus_erythematosus" class="mw-redirect" title="Systemic lupus erythematosus">Systemic lupus erythematosus</a></li> <li><a href="/wiki/Pityriasis_rubra_pilaris" title="Pityriasis rubra pilaris">Pityriasis rubra pilaris</a></li> <li><a href="/wiki/Parapsoriasis" title="Parapsoriasis">Parapsoriasis</a></li> <li><a href="/wiki/Ichthyosis" title="Ichthyosis">Ichthyosis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Blister" title="Blister">Blistering</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Herpes" title="Herpes">Herpes simplex</a></li> <li><a href="/wiki/Herpes_zoster" class="mw-redirect" title="Herpes zoster">Herpes zoster</a></li> <li><a href="/wiki/Chickenpox" title="Chickenpox">Varicella</a></li> <li><a href="/wiki/Impetigo" title="Impetigo">Bullous impetigo</a></li> <li><a href="/wiki/Contact_dermatitis" title="Contact dermatitis">Acute contact dermatitis</a></li> <li><a href="/wiki/Pemphigus_vulgaris" title="Pemphigus vulgaris">Pemphigus vulgaris</a></li> <li><a href="/wiki/Bullous_pemphigoid" title="Bullous pemphigoid">Bullous pemphigoid</a></li> <li><a href="/wiki/Dermatitis_herpetiformis" title="Dermatitis herpetiformis">Dermatitis herpetiformis</a></li> <li><a class="mw-selflink selflink">Porphyria cutanea tarda</a></li> <li><a href="/wiki/Epidermolysis_bullosa_simplex" title="Epidermolysis bullosa simplex">Epidermolysis bullosa simplex</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Papule" title="Papule">Papular</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Scabies" title="Scabies">Scabies</a></li> <li><a href="/wiki/Insect_bites_and_stings" class="mw-redirect" title="Insect bites and stings">Insect bite reactions</a></li> <li><a href="/wiki/Lichen_planus" title="Lichen planus">Lichen planus</a></li> <li><a href="/wiki/Miliaria" title="Miliaria">Miliaria</a></li> <li><a href="/wiki/Keratosis_pilaris" title="Keratosis pilaris">Keratosis pilaris</a></li> <li><a href="/wiki/Lichen_spinulosus" title="Lichen spinulosus">Lichen spinulosus</a></li> <li><a href="/wiki/Transient_acantholytic_dermatosis" title="Transient acantholytic dermatosis">Transient acantholytic dermatosis</a></li> <li><a href="/wiki/Lichen_nitidus" title="Lichen nitidus">Lichen nitidus</a></li> <li><a href="/wiki/Pityriasis_lichenoides_et_varioliformis_acuta" title="Pityriasis lichenoides et varioliformis acuta">Pityriasis lichenoides et varioliformis acuta</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pustule" class="mw-redirect" title="Pustule">Pustular</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Acne_vulgaris" class="mw-redirect" title="Acne vulgaris">Acne vulgaris</a></li> <li><a href="/wiki/Rosacea" title="Rosacea">Rosacea</a></li> <li><a href="/wiki/Folliculitis" title="Folliculitis">Folliculitis</a></li> <li><a href="/wiki/Impetigo" title="Impetigo">Impetigo</a></li> <li><a href="/wiki/Candidiasis" title="Candidiasis">Candidiasis</a></li> <li><a href="/wiki/Neisseria_gonorrhoeae" title="Neisseria gonorrhoeae">Gonococcemia</a></li> <li><a href="/wiki/Dermatophyte" title="Dermatophyte">Dermatophyte</a></li> <li><a href="/wiki/Coccidioidomycosis" title="Coccidioidomycosis">Coccidioidomycosis</a></li> <li><a href="/wiki/Subcorneal_pustular_dermatosis" class="mw-redirect" title="Subcorneal pustular dermatosis">Subcorneal pustular dermatosis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Hypopigmented</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Tinea_versicolor" title="Tinea versicolor">Tinea versicolor</a></li> <li><a href="/wiki/Vitiligo" title="Vitiligo">Vitiligo</a></li> <li><a href="/wiki/Pityriasis_alba" title="Pityriasis alba">Pityriasis alba</a></li> <li><a href="/wiki/Postinflammatory_hyperpigmentation" title="Postinflammatory hyperpigmentation">Postinflammatory hyperpigmentation</a></li> <li><a href="/wiki/Tuberous_sclerosis" title="Tuberous sclerosis">Tuberous sclerosis</a></li> <li><a href="/wiki/Idiopathic_guttate_hypomelanosis" title="Idiopathic guttate hypomelanosis">Idiopathic guttate hypomelanosis</a></li> <li><a href="/wiki/Leprosy" title="Leprosy">Leprosy</a></li> <li><a href="/wiki/Mycosis_fungoides" title="Mycosis fungoides">Hypopigmented mycosis fungoides</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Without<br /> epidermal<br /> involvement</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Red" scope="row" class="navbox-group" style="width:1%">Red</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Blanchable<br /> <a href="/wiki/Erythema" title="Erythema">Erythema</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Generalized</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Drug_eruption" title="Drug eruption">Drug eruptions</a></li> <li><a href="/wiki/Exanthem" title="Exanthem">Viral exanthems</a></li> <li><a href="/wiki/Erythema_toxicum_neonatorum" title="Erythema toxicum neonatorum">Toxic erythema</a></li> <li><a href="/wiki/Systemic_lupus_erythematosus" class="mw-redirect" title="Systemic lupus erythematosus">Systemic lupus erythematosus</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Localized</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cellulitis" title="Cellulitis">Cellulitis</a></li> <li><a href="/wiki/Abscess" title="Abscess">Abscess</a></li> <li><a href="/wiki/Boil" title="Boil">Boil</a></li> <li><a href="/wiki/Erythema_nodosum" title="Erythema nodosum">Erythema nodosum</a></li> <li><a href="/wiki/Carcinoid_syndrome" title="Carcinoid syndrome">Carcinoid syndrome</a></li> <li><a href="/wiki/Fixed_drug_eruption" class="mw-redirect" title="Fixed drug eruption">Fixed drug eruption</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Specialized</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Urticaria" class="mw-redirect" title="Urticaria">Urticaria</a></li> <li>Erythema (<a href="/wiki/Erythema_multiforme" title="Erythema multiforme">Multiforme</a></li> <li><a href="/wiki/Erythema_chronicum_migrans" class="mw-redirect" title="Erythema chronicum migrans">Migrans</a></li> <li><a href="/wiki/Erythema_gyratum_repens" title="Erythema gyratum repens">Gyratum repens</a></li> <li><a href="/wiki/Erythema_annulare_centrifugum" title="Erythema annulare centrifugum">Annulare centrifugum</a></li> <li><a href="/wiki/Erythema_ab_igne" title="Erythema ab igne">Ab igne</a>)</li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Nonblanchable<br /> Purpura</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Macular</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Thrombocytopenic_purpura" title="Thrombocytopenic purpura">Thrombocytopenic purpura</a></li> <li><a href="/wiki/Solar_purpura" title="Solar purpura">Actinic/solar purpura</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Papular</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Disseminated_intravascular_coagulation" title="Disseminated intravascular coagulation">Disseminated intravascular coagulation</a></li> <li><a href="/wiki/Vasculitis" title="Vasculitis">Vasculitis</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Indurated</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Scleroderma" title="Scleroderma">Scleroderma</a>/<a href="/wiki/Morphea" title="Morphea">morphea</a></li> <li><a href="/wiki/Granuloma_annulare" title="Granuloma annulare">Granuloma annulare</a></li> <li><a href="/wiki/Lichen_sclerosus" title="Lichen sclerosus">Lichen sclerosis et atrophicus</a></li> <li><a href="/wiki/Necrobiosis_lipoidica" title="Necrobiosis lipoidica">Necrobiosis lipoidica</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Miscellaneous<br /> disorders</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Ulcer_(dermatology)" title="Ulcer (dermatology)">Ulcers</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li class="mw-empty-elt"></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Hair</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Telogen_effluvium" title="Telogen effluvium">Telogen effluvium</a></li> <li><a href="/wiki/Androgenic_alopecia" class="mw-redirect" title="Androgenic alopecia">Androgenic alopecia</a></li> <li><a href="/wiki/Alopecia_areata" title="Alopecia areata">Alopecia areata</a></li> <li><a href="/wiki/Systemic_lupus_erythematosus" class="mw-redirect" title="Systemic lupus erythematosus">Systemic lupus erythematosus</a></li> <li><a href="/wiki/Tinea_capitis" title="Tinea capitis">Tinea capitis</a></li> <li><a href="/wiki/Loose_anagen_syndrome" title="Loose anagen syndrome">Loose anagen syndrome</a></li> <li><a href="/wiki/Lichen_planopilaris" class="mw-redirect" title="Lichen planopilaris">Lichen planopilaris</a></li> <li><a href="/wiki/Folliculitis_decalvans" title="Folliculitis decalvans">Folliculitis decalvans</a></li> <li><a href="/wiki/Pseudofolliculitis_barbae" title="Pseudofolliculitis barbae">Acne keloidalis nuchae</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Nail_(anatomy)" title="Nail (anatomy)">Nail</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Onychomycosis" title="Onychomycosis">Onychomycosis</a></li> <li><a href="/wiki/Psoriasis" title="Psoriasis">Psoriasis</a></li> <li><a href="/wiki/Paronychia" title="Paronychia">Paronychia</a></li> <li><a href="/wiki/Ingrown_nail" title="Ingrown nail">Ingrown nail</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Mucous_membrane" title="Mucous membrane">Mucous<br /> membrane</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Aphthous_stomatitis" title="Aphthous stomatitis">Aphthous stomatitis</a></li> <li><a href="/wiki/Oral_candidiasis" title="Oral candidiasis">Oral candidiasis</a></li> <li><a href="/wiki/Lichen_planus" title="Lichen planus">Lichen planus</a></li> <li><a href="/wiki/Leukoplakia" title="Leukoplakia">Leukoplakia</a></li> <li><a href="/wiki/Pemphigus" title="Pemphigus">Pemphigus vulgaris</a></li> <li><a href="/wiki/Mucous_membrane_pemphigoid" title="Mucous membrane pemphigoid">Mucous membrane pemphigoid</a></li> <li><a href="/wiki/Cicatricial_pemphigoid" class="mw-redirect" title="Cicatricial pemphigoid">Cicatricial pemphigoid</a></li> <li><a href="/wiki/Herpesviridae" title="Herpesviridae">Herpesvirus</a></li> <li><a href="/wiki/Coxsackievirus" title="Coxsackievirus">Coxsackievirus</a></li> <li><a href="/wiki/Syphilis" title="Syphilis">Syphilis</a></li> <li><a href="/wiki/Histoplasmosis" title="Histoplasmosis">Systemic histoplasmosis</a></li> <li><a href="/wiki/Squamous-cell_carcinoma" title="Squamous-cell carcinoma">Squamous-cell carcinoma</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Vesiculobullous_disease" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Vesiculobullous_disease" title="Template:Vesiculobullous disease"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Vesiculobullous_disease" title="Template talk:Vesiculobullous disease"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Vesiculobullous_disease" title="Special:EditPage/Template:Vesiculobullous disease"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Vesiculobullous_disease" style="font-size:114%;margin:0 4em"><a href="/wiki/Vesiculobullous_disease" title="Vesiculobullous disease">Vesiculobullous disease</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Acantholysis" title="Acantholysis">Acantholysis</a><br />(<a href="/wiki/Epidermis" title="Epidermis">epidermis</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Pemphigus" scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pemphigus" title="Pemphigus">Pemphigus</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pemphigus_vulgaris" title="Pemphigus vulgaris">Pemphigus vulgaris</a>: <a href="/wiki/Pemphigus_vegetans" title="Pemphigus vegetans">Pemphigus vegetans</a> <ul><li><a href="/wiki/Pemphigus_vegetans_of_Hallopeau" class="mw-redirect" title="Pemphigus vegetans of Hallopeau">of Hallopeau</a></li> <li><a href="/wiki/Pemphigus_vegetans_of_Neumann" class="mw-redirect" title="Pemphigus vegetans of Neumann">of Neumann</a></li></ul></li></ul> </div></td></tr><tr><td colspan="2" class="navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pemphigus_foliaceus" title="Pemphigus foliaceus">Pemphigus foliaceus</a>: <a href="/wiki/Pemphigus_erythematosus" title="Pemphigus erythematosus">Pemphigus erythematosus</a></li> <li><a href="/wiki/Endemic_pemphigus" class="mw-redirect" title="Endemic pemphigus">Endemic pemphigus</a></li></ul> </div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Paraneoplastic_pemphigus" title="Paraneoplastic pemphigus">Paraneoplastic pemphigus</a></li></ul> </div></td></tr><tr><td colspan="2" class="navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/IgA_pemphigus" title="IgA pemphigus">IgA pemphigus</a> <ul><li><a href="/wiki/Subcorneal_pustular_dermatosis" class="mw-redirect" title="Subcorneal pustular dermatosis">Subcorneal pustular</a></li> <li><a href="/wiki/Intraepidermal_neutrophilic_IgA_dermatosis" class="mw-redirect" title="Intraepidermal neutrophilic IgA dermatosis">Intraepidermal neutrophilic</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Transient_acantholytic_dermatosis" title="Transient acantholytic dermatosis">Transient acantholytic dermatosis</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pemphigoid" title="Pemphigoid">Pemphigoid</a><br />(<a href="/wiki/Dermis" title="Dermis">dermis</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><span class="nobold"><i><a href="/wiki/Immunoglobulin_G" title="Immunoglobulin G">IgG</a>:</i></span></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bullous_pemphigoid" title="Bullous pemphigoid">Bullous pemphigoid</a></li> <li><a href="/wiki/Cicatricial_pemphigoid" class="mw-redirect" title="Cicatricial pemphigoid">Cicatricial pemphigoid</a> <ul><li><a href="/wiki/Localized_cicatricial_pemphigoid" class="mw-redirect" title="Localized cicatricial pemphigoid">Localised</a></li></ul></li> <li><a href="/wiki/Gestational_pemphigoid" title="Gestational pemphigoid">Gestational pemphigoid</a></li> <li><a href="/wiki/Pemphigoid_nodularis" title="Pemphigoid nodularis">Pemphigoid nodularis</a></li> <li><a href="/wiki/Epidermolysis_bullosa_acquisita" title="Epidermolysis bullosa acquisita">Epidermolysis bullosa acquisita</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><span class="nobold"><i><a href="/wiki/Immunoglobulin_A" title="Immunoglobulin A">IgA</a>:</i></span></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Linear_IgA_bullous_dermatosis" title="Linear IgA bullous dermatosis">Linear IgA bullous dermatosis</a> <ul><li><a href="/wiki/Childhood_linear_IgA_disease" class="mw-redirect" title="Childhood linear IgA disease">Childhood</a></li> <li><a href="/wiki/Adult_linear_IgA_disease" class="mw-redirect" title="Adult linear IgA disease">Adult</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other <a href="/wiki/Bullous" class="mw-redirect" title="Bullous">bullous</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Dermatitis_herpetiformis" title="Dermatitis herpetiformis">Dermatitis herpetiformis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">In diseases<br />classified elsewhere</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a class="mw-selflink selflink">Porphyria cutanea tarda</a></li> <li><a href="/wiki/Lupus" title="Lupus">Bullous lupus erythematosus</a></li> <li><a href="/wiki/PUVA-induced_acrobullous_dermatosis" title="PUVA-induced acrobullous dermatosis">PUVA-induced acrobullous dermatosis</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Heme_metabolism_disorders" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Heme_metabolism_disorders" title="Template:Heme metabolism disorders"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Heme_metabolism_disorders" title="Template talk:Heme metabolism disorders"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Heme_metabolism_disorders" title="Special:EditPage/Template:Heme metabolism disorders"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Heme_metabolism_disorders" style="font-size:114%;margin:0 4em"><a href="/wiki/Heme" title="Heme">Heme</a> metabolism disorders</div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Porphyria" title="Porphyria">Porphyria</a>,<br /><a href="/wiki/Hepatic_porphyria" title="Hepatic porphyria">hepatic</a> and <a href="/wiki/Erythropoietic_porphyria" title="Erythropoietic porphyria">erythropoietic</a><br />(<a href="/wiki/Porphyrin" title="Porphyrin">porphyrin</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><span class="nobold"><i>early mitochondrial:</i></span></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Aminolevulinic_acid_dehydratase_deficiency_porphyria" title="Aminolevulinic acid dehydratase deficiency porphyria">ALAD porphyria</a></li> <li><a href="/wiki/Acute_intermittent_porphyria" title="Acute intermittent porphyria">Acute intermittent porphyria</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><span class="nobold"><i>cytoplasmic:</i></span></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Gunther_disease" title="Gunther disease">Gunther disease/congenital erythropoietic porphyria</a></li> <li><a class="mw-selflink selflink">Porphyria cutanea tarda</a>/<a href="/wiki/Hepatoerythropoietic_porphyria" title="Hepatoerythropoietic porphyria">Hepatoerythropoietic porphyria</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><span class="nobold"><i>late mitochondrial:</i></span></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hereditary_coproporphyria" title="Hereditary coproporphyria">Hereditary coproporphyria</a></li> <li><a href="/wiki/Harderoporphyria" title="Harderoporphyria">Harderoporphyria</a></li> <li><a href="/wiki/Variegate_porphyria" title="Variegate porphyria">Variegate porphyria</a></li> <li><a href="/wiki/Erythropoietic_protoporphyria" title="Erythropoietic protoporphyria">Erythropoietic protoporphyria</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Hereditary_hyperbilirubinemia" title="Hereditary hyperbilirubinemia">Hereditary hyperbilirubinemia</a><br />(<a href="/wiki/Bilirubin" title="Bilirubin">bilirubin</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><span class="nobold"><i>unconjugated:</i></span></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Gilbert%27s_syndrome" title="Gilbert's syndrome">Gilbert's syndrome</a></li> <li><a href="/wiki/Crigler%E2%80%93Najjar_syndrome" title="Crigler–Najjar syndrome">Crigler–Najjar syndrome</a></li> <li><a href="/wiki/Lucey%E2%80%93Driscoll_syndrome" title="Lucey–Driscoll syndrome">Lucey–Driscoll syndrome</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><span class="nobold"><i>conjugated:</i></span></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Dubin%E2%80%93Johnson_syndrome" title="Dubin–Johnson syndrome">Dubin–Johnson syndrome</a></li> <li><a href="/wiki/Rotor_syndrome" title="Rotor syndrome">Rotor syndrome</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table></div>    </div><noscript><img src="https://login.wikimedia.org/wiki/Special:CentralAutoLogin/start?type=1x1" alt="" width="1" height="1" style="border: none; position: absolute;"></noscript> <div class="printfooter" data-nosnippet="">Retrieved from "<a dir="ltr" href="https://en.wikipedia.org/w/index.php?title=Porphyria_cutanea_tarda&oldid=1257258023">https://en.wikipedia.org/w/index.php?title=Porphyria_cutanea_tarda&oldid=1257258023</a>"</div></div> <div id="catlinks" class="catlinks" data-mw="interface"><div 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